DIETARY NITRATE SUPPLEMENTS AND AEROBIC EXERCISE MODIFY FRAILTY IN AN AGE-DEPENDENT MANNER IN FEMALE C57BL/6 MICE

Abstract We previously demonstrated that aerobic exercise attenuates the development of frailty in older female mice. Here we combine the common dietary supplement, sodium nitrate, with aerobic exercise to determine if this combination will work to attenuate frailty across lifespan. Adult (7-9 months) and aged (24-25 months) female mice were given free access to a running wheel and/or sodium nitrate (1mM, drinking water), or neither for 3 months. We measured blood pressure (tail cuff), running volume, frailty (frailty index), and body composition (DEXA). Blood pressure was unaffected by nitrates or exercise at both ages. While young mice ran more than older mice (3.5±0.4 vs 1.2±0.2 km/day), running was unaffected by nitrates. Older mice were frailer at baseline than younger mice (0.13±0.04 vs 0.03±0.004; p< 0.001). In older sedentary controls, frailty increased over time (0.15±0.02 to 0.19±0.03: p=0.03), but this was prevented by nitrates (0.13± 0.02 to 0.12 ± 0.01), exercise (0.12±0.03 to 0.18±0.03), and both (0.12±0.02 to 0.12±0.01). Older sedentary controls saw age-related weight loss (32.5±3.0g to 29.7±2.3g: p=0.02) which was prevented by exercise or nitrates. In older mice, mortality was highest in sedentary controls (46%) and lowest in exercised mice fed nitrates (0%). In contrast, while exercise attenuated frailty in young mice, nitrates did not. Young mice also had few changes in body composition; none died. While nitrates with or without exercise are beneficial for older mice, they had little effect in younger mice. These results suggest that nitrates alone or with exercise, may help prevent frailty in older females.

1) strategic course for innovation 2) innovation journey 3) leadership for innovation 4) learning for innovation and 5) innovative organizational culture.The collective findings support the notion that for innovation readiness the interplay of main factors is vital and benefits from an approach at the individual, team, organizational and inter-organizational levels.Furthermore, our findings indicate that some factors might be more conditional and other factors might play a more supportive role.Research into innovation readiness of health care organizations is a rather new field.Further research directed toward a framework for innovation readiness might deliver a structured approach for managers of long-term care organizations to embed and assess innovation readiness.Many patients with mild cognitive impairment have alterations in gut microbiota composition and dietary consumption directly modulates gut microbiota; therefore, the quality of a diet may impact cognitive function.Twelve-monthold male Fischer 344 rats (n=10/group) were assigned to a Mediterranean diet (MeDi), Western diet (WD), or Chow for three months to determine the effect of diet in aged animals.Animals underwent neurobehavioral assessments including the Morris water maze (MWM), and radial arm water maze (RAWM).Fecal samples were analyzed via 16S rRNA sequencing.Markers of barrier and immune function in the hippocampus were measured via qPCR.The MeDi (p=0.06) and Chow (p=0.003)groups had a trend to or swam a shorter distance compared to the WD in the MWM.There was no difference in RAWM total errors between Diets (p=0.43).Microbiota analyses exhibited differences in alpha-and beta-diversity.Chow diet had a higher Simpson and Shannon index compared to MeDi (p< 0.02) and WD (p< 0.001).The MeDi (p=0.03) and Chow (p< 0.001) groups had a higher Chao1 index compared to the WD group.Betadiversity differed by Diet for weighted UniFrac (p< 0.03), and unweighted UniFrac (p< 0.001).For barrier integrity, there was a trend for Occludin expression to differ by Diet (p=0.07) but Claudin-5 did not differ (p=0.81).For immune function, the WD group had a trend to have a higher expression of GFAP compared to the MeDi (p=0.05) but a lower Iba-1 expression (p=0.009).A short-term diet had a subtle effect on cognitive performance but modulated microbiota compositions and hippocampal immune marker expression.

DIETARY NITRATE SUPPLEMENTS AND AEROBIC EXERCISE MODIFY FRAILTY IN AN AGE-DEPENDENT MANNER IN FEMALE C57BL/6 MICE Elise Bisset, and Susan Howlett, Dalhousie University, Halifax, Nova Scotia, Canada
We previously demonstrated that aerobic exercise attenuates the development of frailty in older female mice.Here we combine the common dietary supplement, sodium nitrate, with aerobic exercise to determine if this combination will work to attenuate frailty across lifespan.Adult (7-9 months) and aged (24-25 months) female mice were given free access to a running wheel and/or sodium nitrate (1mM, drinking water), or neither for 3 months.We measured blood pressure (tail cuff), running volume, frailty (frailty index), and body composition (DEXA).Blood pressure was unaffected by nitrates or exercise at both ages.While young mice ran more than older mice (3.5±0.4 vs 1.2±0.2km/day), running was unaffected by nitrates.Older mice were frailer at baseline than younger mice (0.13±0.04 vs 0.03±0.004;p< 0.001).In older sedentary controls, frailty increased over time (0.15±0.02 to 0.19±0.03:p=0.03), but this was prevented by nitrates (0.13± 0.02 to 0.12 ± 0.01), exercise (0.12±0.03 to 0.18±0.03),and both (0.12±0.02 to 0.12±0.01).Older sedentary controls saw age-related weight loss (32.5±3.0g to 29.7±2.3g:p=0.02) which was prevented by exercise or nitrates.In older mice, mortality was highest in sedentary controls (46%) and lowest in exercised mice fed nitrates (0%).In contrast, while exercise attenuated frailty in young mice, nitrates did not.Young mice also had few changes in body composition; none died.While nitrates with or without exercise are beneficial for older mice, they had little effect in younger mice.These results suggest that nitrates alone or with exercise, may help prevent frailty in older females.

Massachusetts, United States
The COVID-19 pandemic majorly impacted geriatric specialty training.To better understand this impact, a survey study was conducted to examine the pandemic's unique impact on geropsychology training.Participants (N=62) included psychology trainees specializing in geropsychology and psychologists providing geropsychology training.The majority of participants identified as white (90.3%), female (87.1%), and 30-39 years old.Using a 5-point Likert scale ranging from "not at all impactful" to "extremely impactful", participants rated their subjective experience on how the pandemic positively and negatively affected geropsychology training in three functional competency areas (assessment, intervention, and consultation) consistent with the Pikes Peak Model for Geropsychology Training.A 2x3 mixed design repeated measures ANOVA was conducted to examine similarities and differences in trainees' and supervisors' perceptions of the pandemic's impact on the competency domains.Results indicate that supervisors' and trainees' perception of the pandemic's negative impacts aligned, F(1,43)=.01,p=.931.Results were consistent across all competency domains, F(2,86)=1.39,p=.26; however, perceptions of the positive impacts significantly differed, F(2,84)=6.459,p=.002.Overall, both trainees and supervisors perceived more positive impacts on intervention and consultation compared to assessment, t(43)=3.54,p≤.001.However, trainees (M=1.8,SD=.112) reported more positive impacts overall compared to supervisors (M=1.3,SD=.09), F(1,42)=9.08,p=.004.These findings have significant implications for the level of competence in emerging geropsychologists', particularly in the areas of cognitive and capacity assessments.Recommendations for additional assessment training and supervision will be provided.

DIFFERENCES IN FRAILTY BETWEEN TRADITIONAL MEDICARE AND MEDICARE ADVANTAGE BENEFICIARIES
Sandra Shi 1 , Brianne Olivieri-Mui 2 , Ellen McCarthy 1 , and Dae Hyun Kim 3 , 1. Hebrew SeniorLife, Boston, Massachusetts, United States, 2. Northeastern University, Boston, Massachusetts, United States,3. Harvard Medical School,Boston,Massachusetts,United States Medicare Advantage (MA) plans cover at a minimum the same services as fee-for-service Medicare (FFS), but may target patient populations that differ in health and frailty.Leveraging 2011 and 2015 National Health and Aging Trends Study (NHATS) linked to Medicare claims, we classified participants as FFS or MA beneficiaries based on 12 months of Medicare enrollment.We calculated a deficit accumulation-based frailty index (FI) and phenotypic frailty from the survey assessment.All analyses accounted for the complex sampling design and weighted to reflect national estimates.In 2011, MA beneficiaries were more likely to be female (MA vs FFS: 59.1% vs 55.6%), Black (9.6% vs 7.4%) or other race (9.8% vs 5.2%), and to have an estimated income <$25,000 (44.5% vs 39.4%).Although the mean FI was similar between MA and FFS (MA vs FFS: 0.25 vs 0.25), MA beneficiaries were more likely to have mild frailty by FI (20.1% vs 18.6%) but less likely to have severe frailty by FI (10.0%vs 11.7%) or phenotypic frailty (13.5% vs 14.0%).MA beneficiaries had a higher prevalence of some comorbidities, such as hypertension (MA vs FFS: 64.9% vs 63.3%) and diabetes (24.4% vs 23.3%), but a lower mean number of ADL disability (0.32 vs 0.39).In 2015 the results were similar, although MA beneficiaries had a higher prevalence of pre-frailty (MA 46.0% vs 43.3%).In conclusion, MA beneficiaries seem to have a lower level of deficit-accumulation frailty and phenotypic frailty.This difference is driven by comorbidities, but not functional disability.

DIFFERENCES IN RESILIENCE AMONG MIDLIFE AND OLDER ADULTS BY SEXUAL AND GENDER IDENTITY AND BY GENERATION
Christi Nelson, and Karen Fredriksen-Goldsen, University of Washington, Seattle, Washington, United States Sexual and gender minority (SGM) (i.e., lesbian, gay, bisexual, sexual diverse, and transgender) midlife and older adults face specific health, social, and structural inequities in addition to the late-life challenges experienced by older adults in general.Extant research had largely examined health disparities and related risk and protective factors among SGM individuals as a homogeneous group, without attending to the heterogeneity among the subgroups and differing generations.Most research has also focused on stress with limited attention to resilience, even though